5 ms·

Wow. "We conclude that it is impossible to say that taking SSRI antidepressants is worthwhile, or even completely safe. People need all this information to mak

Wow. "We conclude that it is impossible to say that taking SSRI antidepressants is worthwhile, or even completely safe. People need all this information to make informed decisions about whether or not to take antidepressants."

tinyhouse 4y ago
This is indeed a wow statement. Not from the field and completely anecdotal. I know 5 people in my family taking Lexapro for anxiety and all with significantly improved results after a month or two of use. I know it's not depression but still.
- starkd 4y ago
  There's no doubt there's a short term efficacy. The real issue is the waning efficacy over long term with risk of dependence.
  - zionic 4y ago
    I worry about long-term users skipping a day and going deep down a blackhole. Some correlate mass shootings and heavy antidepressant use (then rapid cessation).
    - ttpphd 4y ago
      That is a moral panic whipped up by pro-gun crusaders who want to blame everything but the easy availability of guns for America's domestic terrorist problem
    - bigbillheck 4y ago
      > Some correlate mass shootings and heavy antidepressant use (then rapid cessation). Seems like an attempt to deflect from much more likely issues.
    - pjerem 4y ago
      French people are notoriously heavily using antidepressants and still we have no mass shootings of any kind.
      - nibbleshifter 4y ago
        Legal access to firearms is pretty heavily limited in France compared to the US.
    - starkd 4y ago
      That's a very real risk. Do not suddenly stop these meds.
  - tartoran 4y ago
    Short term to get you out of the dark hole or unstuck the rut, antidepressants are no panacea but are helpful especially combined with some other form of psychotherapy to figure out the underlying problem.
    - starkd 4y ago
      Right. Just don't stay on them for too long and make a plan to discontinue before becoming dependent. They are hard to get off of.
  - runarberg 4y ago
    Don’t discount the successes of a short term efficacy. Depression is a deadly disease. Sometimes a short term efficacy can be the different between life and death. Usually depression is treated with a mix of drugs—such as SSRIs—and psychotherapy. I think health officials are completely aware of the long term effects, and that is why the treatment is most often multi-faceted.
    - starkd 4y ago
      No doubt they can be useful. Unfortunately, I don't have as much confidence as you in our health officials. It seems to resort to the lowest common denominator in recommending treatments. Psychotherapy is complex and it's hard to find a "good" counselor without multiple appointments to find one. It is highly personal treatment that is under the control of a highly unpersonal bureaucracy.
  - kingkawn 4y ago
    As far as I know they were not developed or tested for anything beyond acute <6 month use
    - tinyhouse 4y ago
      Like most meds. The incentive of drug companies is to do enough testing to get an FDA approval (or equivalent in other places).
  - tinyhouse 4y ago
    Again, just anecdotal evidence, but I know people who have been taking it for more than 10 years with good results. One had to increase the dose over time but that's it. We don't know the long term impact of Lexapro and similar drugs to know how big issues the risk of dependence is. It's a tradeoff like everything in life. I agree it's better to find "safer" long term solutions if possible and stopping the meds gradually, but for many people it's not an option, so in the end it's their quality of life vs the long term risk of taking meds. I feel many people who comment on meds like SSRI never really needed them so much so for them the long term safety is a big issue, but when these pills have a huge positive impact on your life then you are more willing to accept it.
- deleted 4y ago
  [deleted]
- LatteLazy 4y ago
  The natural remission rate for depression is about 70%, so plenty of people taking antidepressants think they helped...
mateus1 4y ago
To say the golden standard is useless without providing a better alternative. I find this kind of messaging completely irresponsible and it just contributes to the stigma around mental health and medications.
- 300bps 4y ago
  To say the golden standard is useless without providing a better alternative. If the golden standard were to hit yourself in the head with a hammer, it is very useful to point out that it doesn't seem to help and is not safe. Even if you don't have a better alternative.
- squidbeak 4y ago
  And yet if it's the conclusion of their study and their study is sound, wouldn't it be irresponsible to fudge and mince it?
  - mateus1 4y ago
    I take no issue with the study, I'm taking issue with the messaging around it.
- drno123 4y ago
  Lobotomies and electroshocks were golden standard just a few decades ago.
  - runarberg 4y ago
    No they weren’t. They were a fringe treatment that was popularized by stigma and prejudice. The fake science and the torturous nature behind them were called out many times by real scientists at the time, and simply ignored by health authorities. Heck. Just watch how the treatment was portrait in a Hollywood blockbuster in the 1970s. There is no way One Flew Over the Cuckoo’s Nest would frame lobotomy so badly if it was consider a “golden standard”. Comparing SSRI to lobotomy is a historic revisionism at best.
  - linuxftw 4y ago

tinyhouse 4y ago

This is indeed a wow statement. Not from the field and completely anecdotal. I know 5 people in my family taking Lexapro for anxiety and all with significantly improved results after a month or two of use. I know it's not depression but still.

starkd 4y ago
There's no doubt there's a short term efficacy. The real issue is the waning efficacy over long term with risk of dependence.
- zionic 4y ago
  I worry about long-term users skipping a day and going deep down a blackhole. Some correlate mass shootings and heavy antidepressant use (then rapid cessation).
  - ttpphd 4y ago
    That is a moral panic whipped up by pro-gun crusaders who want to blame everything but the easy availability of guns for America's domestic terrorist problem
  - bigbillheck 4y ago
    > Some correlate mass shootings and heavy antidepressant use (then rapid cessation). Seems like an attempt to deflect from much more likely issues.
  - pjerem 4y ago
    French people are notoriously heavily using antidepressants and still we have no mass shootings of any kind.
    - nibbleshifter 4y ago
      Legal access to firearms is pretty heavily limited in France compared to the US.
  - starkd 4y ago
    That's a very real risk. Do not suddenly stop these meds.
- tartoran 4y ago
  Short term to get you out of the dark hole or unstuck the rut, antidepressants are no panacea but are helpful especially combined with some other form of psychotherapy to figure out the underlying problem.
  - starkd 4y ago
    Right. Just don't stay on them for too long and make a plan to discontinue before becoming dependent. They are hard to get off of.
- runarberg 4y ago
  Don’t discount the successes of a short term efficacy. Depression is a deadly disease. Sometimes a short term efficacy can be the different between life and death. Usually depression is treated with a mix of drugs—such as SSRIs—and psychotherapy. I think health officials are completely aware of the long term effects, and that is why the treatment is most often multi-faceted.
  - starkd 4y ago
    No doubt they can be useful. Unfortunately, I don't have as much confidence as you in our health officials. It seems to resort to the lowest common denominator in recommending treatments. Psychotherapy is complex and it's hard to find a "good" counselor without multiple appointments to find one. It is highly personal treatment that is under the control of a highly unpersonal bureaucracy.
- kingkawn 4y ago
  As far as I know they were not developed or tested for anything beyond acute <6 month use
  - tinyhouse 4y ago
    Like most meds. The incentive of drug companies is to do enough testing to get an FDA approval (or equivalent in other places).
- tinyhouse 4y ago
  Again, just anecdotal evidence, but I know people who have been taking it for more than 10 years with good results. One had to increase the dose over time but that's it. We don't know the long term impact of Lexapro and similar drugs to know how big issues the risk of dependence is. It's a tradeoff like everything in life. I agree it's better to find "safer" long term solutions if possible and stopping the meds gradually, but for many people it's not an option, so in the end it's their quality of life vs the long term risk of taking meds. I feel many people who comment on meds like SSRI never really needed them so much so for them the long term safety is a big issue, but when these pills have a huge positive impact on your life then you are more willing to accept it.
deleted 4y ago
[deleted]
LatteLazy 4y ago
The natural remission rate for depression is about 70%, so plenty of people taking antidepressants think they helped...

mateus1 4y ago

To say the golden standard is useless without providing a better alternative. I find this kind of messaging completely irresponsible and it just contributes to the stigma around mental health and medications.

300bps 4y ago
To say the golden standard is useless without providing a better alternative. If the golden standard were to hit yourself in the head with a hammer, it is very useful to point out that it doesn't seem to help and is not safe. Even if you don't have a better alternative.
squidbeak 4y ago
And yet if it's the conclusion of their study and their study is sound, wouldn't it be irresponsible to fudge and mince it?
- mateus1 4y ago
  I take no issue with the study, I'm taking issue with the messaging around it.
drno123 4y ago
Lobotomies and electroshocks were golden standard just a few decades ago.
- runarberg 4y ago
  No they weren’t. They were a fringe treatment that was popularized by stigma and prejudice. The fake science and the torturous nature behind them were called out many times by real scientists at the time, and simply ignored by health authorities. Heck. Just watch how the treatment was portrait in a Hollywood blockbuster in the 1970s. There is no way One Flew Over the Cuckoo’s Nest would frame lobotomy so badly if it was consider a “golden standard”. Comparing SSRI to lobotomy is a historic revisionism at best.
- linuxftw 4y ago